Recent management strategies after lung transplantation 1. Hemodynamic management Keeping the blood volume as low as possible is the most important principle of hemodynamic management after lung transplantation, and attention must be paid to adjusting hemoglobin and coagulation status. As far as possible, the perfusion pressure of important organs should be ensured by limiting fluid intake and combining low-dose vasoconstrictors with body circulation to avoid fluid overload. Immunosuppressive therapy Polyclonal anti-lymphocyte agents and interleukin 2 receptor antagonists have been more frequently used as induction immunosuppressive agents immediately at the time of lung transplantation to reduce the risk of acute rejection and the incidence of bronchiolitisobliteranssyndrome (BOS) in the distant future. Initial perioperative immunosuppression can be achieved with a triple immunosuppression regimen, with most centers using cortisol, tacrolimus, and morte-macrolimus. The patient’s cortisol dosage is tapered to discontinuation during recovery, and serum drug concentrations of tacrolimus and morte-macrolimus are measured and the dose of the drug is adjusted. In the event of acute rejection (AR), hormone shock therapy is administered and the dose of mortifamolate may be increased. When acute infection cannot be distinguished from AR, tracheoscopic biopsy is recommended to distinguish AR from acute infection according to pathological findings. 3. Prophylactic anti-infective treatment The development of postoperative prophylactic anti-infective strategy should be applied based on the results of donor and recipient sputum culture in a comprehensive assessment. Intravenous ganciclovir is recommended to prevent cytomegalovirus infection regardless of whether cytomegalovirus is detected in donor and recipient sera. Intravenous voriconazole is given to prevent fungal infections, followed by sequential oral therapy after the patient resumes a normal diet. If side effects of voriconazole become apparent during administration, it is possible to switch to itraconazole. Antifungal infection treatment is continued until 6 months postoperatively. If the patient’s creatinine clearance is <50 mL/min, the patient may be switched to caspofungin to prevent fungal infection. Serum cytomegalovirus antigen and galactomannan (GM) test should be monitored regularly during the perioperative period. 4. Monitoring and management of recent postoperative complications PGD is the most common cause of death in the perioperative period of lung transplantation, and its clinical manifestations are mainly progressive injurious pulmonary dysfunction that occurs in the transplanted lung within 72h after lung transplantation without surgical technical problems, lung infection and other clear secondary factors. Treatment measures include strict preoperative donor and recipient selection criteria, refinement of lung perfusion preservation and surgical techniques, postoperative maintenance of negative fluid balance, implementation of protective lung ventilation strategies, and if necessary, ECMO for refractory PGD. Other recent complications that need to be monitored include acute rejection, lung infection, pulmonary torsion, vascular anastomotic complications, thoracic hemorrhage, bronchial anastomotic complications, postoperative cardiovascular complications, pulmonary embolism, graft-versus-host disease, and complications associated with immunosuppressive therapy.